Resistive materials in the form of elastic bands and tubing are inexpensive and highly versatile tools that are often used in therapeutic exercise programs. Companies that manufacture elastic bands ...and tubing provide a line of products that cover a wide range of resistance levels, which are typically distinguished by color. Theoretically, the spectrum of resistance levels makes it possible for rehabilitation personnel to give a patient the band or tubing that best corresponds to the suitable degree of exercise resistance for that patient. Unlike a set of clearly labeled hand-held weights, however, elastic bands and tubing provide no quantitative information on their actual or relative resistance. Therefore, the selection and progression of resistance levels when elastic bands or tubing are used is relatively subjective and often is dependent upon the perceived effort of the patient. To our knowledge, only 2 of the several manufacturers of elastic bands and tubing used in rehabilitation (The Hygenic Corporation, Akron, Ohio, and Lifeline International, Inc, Madison, Wis), provide users with information (limited) on the physical characteristics of their elastic material.
Diabetes mellitus, which results from a failure of the endocrine system to control blood glucose levels within normal limits, affects approximately 15% of the population over the age of 65 in ...developed countries. Between 20-50% of people with diabetes for more than 10 years will experience symmetrical distal sensory neuropathy resulting in a progressive, distal to proximal, loss of sensation in the lower extremities. The most common consequence is plantar ulceration that too often results in partial or total amputation of the foot. While neuropathy is a major permissive factor, plantar ulcers occur at locations of high plantar pressures. The measurement of pressure using tools developed and refined in the field of biomechanics has been shown to be a valuable asset to the management of the foot at risk for ulceration. In particular, the use of in-shoe measuring techniques has the potential to revolutionize the prescription of therapeutic footwear. Biomechanical techniques have also helped to evaluate other consequences of diabetic neuropathy on the foot such as callus formation, foot deformity, limited joint mobility and bony abnormalities. The reduction of afferent information from the lower extremities implies a lack of active feedback thought to be necessary for the control of human movements such as posture and gait. Our results show that diabetic neuropathy results in a significant increase in sway during standing that is not compensated for by other sensory systems. The study of the sagittal plane movements of the same individuals walking on a treadmill showed little effect on the kinematic control of gait when compared to age matched nonneuropathic control groups. This may indicate the dominance of efferent input over afferent feedback during gait. We believe that the study of the biomechanical consequences of diabetes can act as a model for many other diseases that have yet to come under the scrutiny of a multidisciplinary team.
JOSPT: the way ahead Simoneau, Guy G
The journal of orthopaedic and sports physical therapy
42, Številka:
1
Journal Article
Recenzirano
Last Fall, JOSPT conducted an extensive environmental survey that attracted 560 respondents. The survey represented the Journal's many stakeholder groups, including authors, reviewers, editors, ...Orthopaedic and Sports Sections members, individual and institutional subscribers, and international partners. The Journal also held a strategic planning meeting and adopted a plan for the next 2 years. Among other findings, the survey showed that journals remain the most important means by which professionals stay current in the field of musculoskeletal rehabilitation. The survey also highlighted the technological sea change in publishing today. The expansion of JOSPT's online features in recent years, the need to select the "right" technologies, the plethora of content delivery options already available, and the growing demand to read and access the Journal anytime, anywhere, dominated the survey's results. Based on this survey, existing initiatives, and discussion at the planning meeting, JOSPT's plan for the future has at its heart technology as means of developing and disseminating clinically relevant information to improve patient care.
This study aimed to compare and analyse rubber-dome desktop, spring-column desktop and notebook keyboards in terms of key stiffness and fingertip typing force. The spring-column keyboard resulted in ...the highest mean peak contact force (0.86N), followed by the rubber dome desktop (0.68N) and the notebook (0.59N). All these differences were statistically significant. Likewise, the spring-column keyboard registered the highest fingertip typing force and the notebook keyboard the lowest. A comparison of forces showed the notebook (rubber dome) keyboard had the highest fingertip-to-peak contact force ratio (overstrike force), and the spring-column generated the least excess force (as a ratio of peak contact force). The results of this study could aid in optimizing computer key design that could possibly reduce subject discomfort and fatigue.
Abstract Background Factors associated with advanced liver disease have been incompletely explored in HIV/HBV coinfected patients. Objectives To describe liver-related morbidity, mortality, and ...related risk factors, in HIV/HBV coinfected patients. Study design We followed-up 107 consecutive HIV/HBV coinfected patients. Clinical, biological and virological data were collected every 3 months. Liver-related mortality and a composite score were used to define advanced liver disease. Results The patients were mainly sub-Saharan Africans (61%) or Europeans (33%). Forty-four percent of patients had liver biopsy, 78% of patients received lamivudine. Advanced liver disease (ALD) was diagnosed in 19/107 patients during follow-up (mean 4.8 years): 10 extensive fibrosis, 5 cirrhosis, 3 hepatocellular carcinoma resulting from cirrhosis, and 1 fulminant hepatitis following lamivudine withdrawal. Eleven patients died, 4 from HBV-related liver disease. In univariate analysis, male gender, mean HIV and HBV viral loads, and raised AST/ALT transaminases were associated with increased risk of ALD. The strongest associations, in a multivariate model, were mean AST transaminase and cumulated time receiving lamivudine, with a favourable effect. 39% of patients with increased mean AST presented with ALD, versus 7% when normal mean AST (Relative Risk 5.5). Conclusions During HIV/HBV coinfection, transaminase levels are strongly associated with ALD. Normal mean AST has a high negative predictive value, contrary to previously reported data in HIV/HCV patients.
A study was conducted on 90 experienced office workers to determine how commercially available alternative computer keyboards affected wrist and forearm posture. The alternative keyboards tested had ...the QWERTY layout of keys and were of three designs: split fixed angle, split adjustable angle, and vertically inclined (tilted or tented). When set up correctly, commercially available split keyboards reduced mean ulnar deviation of the right and left wrists from 12° to within 5° of a neutral position compared with a conventional keyboard. The finding that split keyboards place the wrist closer to a neutral posture in the radial/ulnar plane substantially reduces one occupational risk factor of workrelated musculoskeletal disorders (WMSDs): ulnar deviation of the wrist. Applications of this research include commercially available computer keyboard designs that typists can use and ergonomists can recommend to their clients in order to minimize wrist ulnar deviation from typing.